Aberrant intervertebral motion in patients with treatment-resistant nonspecific low back pain: a retrospective cohort study and control comparison

Breen, Alexander; Mellor, Fiona E.

doi:10.1007/s00586-018-5666-1

Cited by 16 publications

(28 citation statements)

References 42 publications

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“…Motion sharing inequality (MSI) and motion sharing variability (MSV) Asynchronous intervertebral motion during standardised trunk bending has been found to be greater in patients with nonspecific back pain than in controls and may represent a form of movement impairment [5,22,42]. Numerically, MSI is the average range of differences in the sharing of motion by each intervertebral level at each data point throughout the motion and reflects inequality of restraint across levels.…”

Section: Variables Under Considerationmentioning

confidence: 99%

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Intrasubject repeatability of in vivo intervertebral motion parameters using quantitative fluoroscopy

2018

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Purpose In vivo quantification of intervertebral motion through imaging has progressed to a point where biomarkers for low back pain are emerging. This makes possible deeper study of the condition's biometrics. However, the measurement of change over time involves error. The purpose of this prospective investigation is to determine the intrasubject repeatability of six in vivo intervertebral motion parameters using quantitative fluoroscopy. Methods Intrasubject reliability (ICC) and minimal detectable change (MDC) of baseline to 6-week follow-up measurements were calculated for six lumbar spine intervertebral motion parameters in 109 healthy volunteers. A standardised quantitative fluoroscopy (QF) protocol was used to provide measurements in the coronal and sagittal planes using both passive recumbent and active weight-bearing motion. Parameters were: intervertebral range of motion (IV-RoM), laxity, motion sharing inequality (MSI), motion sharing variability (MSV), flexion translation and anterior disc height change during flexion. Results The best overall intrasubject reliability (ICC) and agreement (MDC) were for disc height (ICC 0.89, MDC 43%) and IV-RoM (ICC 0.96, MDC 60%), and the worst for MSV (ICC 0.04, MDC 408%). Laxity, MSI and translation had acceptable reliability (most ICCs > 0.60), but not agreement (MDC > 85%). Conclusion Disc height and IV-RoM measurement using QF could be considered for randomised trials, while laxity, MSI and translation could be considered for moderators, correlates or mediators of patient-reported outcomes. MSV had both poor reliability and agreement over 6 weeks. Graphical abstract These slides can be retrieved under Electronic Supplementary Material.

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Section: Variables Under Considerationmentioning

confidence: 99%

“…4), and MSV may be considered to reflect intervertebral motion control. Details of these variables and methodologies have been published elsewhere [5,42]. However, no observer repeatability statistics have yet been published for MSI and MSV.…”

Section: Variables Under Considerationmentioning

confidence: 99%

Intrasubject repeatability of in vivo intervertebral motion parameters using quantitative fluoroscopy

2018

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“…Furthermore, our study includes a somewhat limited sample size. However, similar studies worked with comparable or lower (24 or 37) samples [18,21,24,25]. Moreover, limited number of measurement points selected manually (i.e., 4 corners) could adversely affect precision [18].…”

Section: Discussionmentioning

confidence: 99%

“…However, their parameter of segmental distribution of lordosis (mode 2) was only partially able to describe where the curve is uneven without quantifying the location of the apex and only healthy subjects were included. Recently, quantitative fluoroscopy provided detailed information on lumbar segmental motion characteristics (MSI � motion sharing inequality) in recumbent passive flexion [21]. However, the use of special setup and ionizing radiation limits its use in daily clinical practice.…”

Section: Introductionmentioning

confidence: 99%

Assessment of Lumbar Lordosis Distribution with a Novel Mathematical Approach and Its Adaptation for Lumbar Intervertebral Disc Degeneration

Sándor

Ráthonyi

Dinya

2020

Computational and Mathematical Methods in Medicine

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Introduction. Low back pain and disc degeneration could be linked to global spinal geometry. Our study aimed to develop a reliable new mathematical method to assess the local distribution of total lumbar lordosis with a single numeric parameter and compare it with lumbar intervertebral disc degeneration using routine MRI scans. Methods. An online, open access, easy-to-use platform for measurements was developed based on a novel mathematical approach using MRIs of 60 patients. Our Spinalyze Software can be used online with uploaded MRIs. Several new parameters were introduced and assessed to describe variation in segmental lordosis distribution with a single numerical value. The Pfirrmann grading system was used for the classification of lumbar intervertebral disc degeneration. Relationships were investigated between the grade categories of L1-S1 lumbar discs and the MRI morphological parameters with correlation analysis. Results. Results confirm that the determination of measurement points and calculated parameters are reliable (ICCs and Pearson r values > 0.90), and these parameters were independent of gender. The digression percentage (K%), one of our new parameters, did not show a statistical relationship with the Cobb-angle. According to our results, the maximum deflection breaking-point of lumbar lordosis and its location can be different with the same Cobb-angle and the distribution of global lordosis is uneven because the shape of the lumbar lordosis is shifted downward and centered around the L4 lumbar vertebra. The interobserver reliability of the Pfirrmann grades reading was in the excellent agreement category (88.33% agreement percentage, 0.84 kappa), and digression percentage (K%) showed a significant negative correlation with all L1-S1 disc grades with increasing r correlation values. This means that the smaller the value of digression percentage (K%), the more the number of worn discs in the lower lumbar sections. Conclusions. Spinalyze Software based on a novel mathematical approach provides a free, easy-to-use, reliable, and online measurement tool using standard MRIs to approximate the curvature of lumbar lordosis. The new reliable K% (digression percentage) is one single quantitative parameter to assess the local distribution of total lumbar lordosis. The results indicate that digression percentage (K%) may possibly be associated with the development of lumbar intervertebral disc degeneration. Further evaluation is needed to assess its behavior and advantage.

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“…This is especially true if there is evidence of additional imposed mechanical disruption of motion segments (such as resected fusion) (14). However, these factors were again only significant during passive recumbent motion, where muscular activity was excluded and motion patterns reflected purely inter vertebral restraint.…”

Section: Making Correctionsmentioning

confidence: 94%

Aberrant intervertebral motion in patients with treatment-resistant nonspecific low back pain: a retrospective cohort study and control comparison

Cited by 16 publications

References 42 publications

Intrasubject repeatability of in vivo intervertebral motion parameters using quantitative fluoroscopy

Intrasubject repeatability of in vivo intervertebral motion parameters using quantitative fluoroscopy

Assessment of Lumbar Lordosis Distribution with a Novel Mathematical Approach and Its Adaptation for Lumbar Intervertebral Disc Degeneration

Anti-directional cervical intervertebral motion: could it have gone any other way?

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